Provider Demographics
NPI:1366697633
Name:DUNBAR, JUANITA (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JUANITA
Middle Name:
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 FREDERICK DOUGLASS BLVD
Mailing Address - Street 2:APT. 3F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-2701
Mailing Address - Country:US
Mailing Address - Phone:917-941-3343
Mailing Address - Fax:
Practice Address - Street 1:2518 FREDERICK DOUGLASS BLVD
Practice Address - Street 2:APT. 3F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-2701
Practice Address - Country:US
Practice Address - Phone:917-941-3343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-29
Last Update Date:2008-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013870235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist